Brought to you by Cheshire Medical Center

Center for Population Health at Cheshire Medical Center staff, Tricia J. Wadleigh, MPH, Partner Manager, and Candace Hubner, MPH, Population Health Epidemiologist

Making positive, impactful change to the health and well-being of people in your community requires an informed understanding of their needs and scaled strategies to meet those needs.

That’s why the Center for Population Health (CPH) at Cheshire Medical Center is collaborating with others in the Monadnock Region to be one of 18 organizations nationwide participating in SCALE (Spreading Community Accelerators through Learning and Evaluation), an initiative designed to help communities improve health, well-being, and equity by transforming the way they think and act as they work in partnership with people experiencing the specific issues they are seeking to address.

In early 2015, with the generous support of the Robert Wood Johnson Foundation, the SCALE initiative was launched by four 100 Million Healthier Lives partner organizations (Institute for Healthcare Improvement [IHI], Communities Joined in Action [CJA], Community Solutions [CS], and Network for Regional Healthcare Improvement [NRHI]).

A Model of Community Transformation

SCALE’s core strategies include fostering healthy, thriving equitable communities; creating connections across different types of organizations, like local government, faith-based organizations, schools, and healthcare organizations; and developing new culture and mindsets.

SCALE uses a model of community transformation entitled Community of Solutions, to meet communities where they are, beginning small, and as capability increases, applying skills and behaviors to address larger sets of challenges with growing and spreading impact.

CPH received a grant from the Robert Wood Johnson Foundation for the second phase of SCALE-to “spread” community solutions skills to a half-dozen communities in the Monadnock Region and other partner organizations throughout the state.

“Right now we’re determining what that might look like,” said Tricia Wadleigh, Partner Manager with CPH and Local Improvement Advisor with SCALE. “We’re educating the community and giving (the initiative) exposure. We’re tackling each community solutions skill set one at a time, providing people with skills they can take back to their organizations and use.”

“We’re accelerating the population health work of the participating communities and evaluating it in new ways,” said Wadleigh. “It’s about measuring what matters-improving lives and making sure people are thriving.”

Surveying and measuring for ongoing improvement

An important tool in measuring outcomes with an eye for improvement is the 100 Million Healthier Lives Adult Wellbeing Assessment survey, developed by the Institute for Healthcare Improvement (the SCALE convening organization) for 100 Million Healthier Lives. The survey is administered in the participating community to identify community specific data and to establish a base-line. The surveys are repeated every 1-2 months to monitor project progress and identify any need for modifications to specific efforts.

The survey asks for information in such categories as socio-economic status, race, gender, income, health, education level, and military service. It also includes “equity- related” questions about emotional, physical and financial well-being, now and in five years -1 being the lowest level and 10 the highest on the “ladder.”

“We want to find the folks who aren’t thriving and move them up the ladder as much as possible,” said Wadleigh. “We want to find people who could benefit most from policy and environmental changes.”

If well-being scores aren’t moving up ladder rungs, Wadleigh added, she will work to make improvements in needed areas. That may mean, for example, educating people in the community about food insecurity and access.

To learn more about the Center for Population Health at Cheshire Medical Center, visit

For more information about the vision and mission of 100 Million Healthier Lives and the SCALE Initiative, visit